A father I know took his son to visit some Universities during his senior year. At one school the computer department had a virtual reality lab. During the tour the professor asked for volunteers and the dad agreed. They put headgear on him so his vision and hearing where completely covered in order for him to be immersed in the virtual environment. They switched on the program and he was transported to some kind of science fiction lab way up on a platform. The height was tremendous. There was a narrow pathway he was supposed to walk across.
Turns out he was afraid of heights…and he completely froze.
He knew that what he was seeing and hearing was completely made up. Nothing was real about it. He knew he was on a concrete floor in the basement of building. He knew he was looking at a video screen built into the headgear. He knew that he could step off the edge and nothing would happen. However, his body did NOT agree. His body responded to the sensory input as if it was real. He knew he shouldn’t be afraid but he was actually terrified.
That is what happens with anxiety. Even though the worry and fear is completely made up, the physical reaction is real. In some ways, things that are purely in the imagination are harder to dispute than the virtual reality. (You can’t take off the headgear.) Anxiety thinking is pure fiction but the physical reaction is real. That is why anxiety disorders are so confusing.
But this is also why exposure works. Exposure is voluntarily experiencing the fear without trying to fix it. For the dad, if he had time and with repetition he would be able to walk the path and even step off the ledge without any fear. This would happen if he kept on the gear and walked off the edge over and over. As he puts the virtual reality to the test by walking the path and stepping off he disproves to his nervous system that there is threat. The fear is made up. Exposure proves that nothing terrible happens. Eventually his nervous system and mind sync back up and the fear goes away. Exposure disproves the fear by putting it to the test.